The proportion of laryngocarcinoma rises incessantly among all oncological diseases, having reached 8percent in the recent years, while almost 70 percent of the patients suffer from the most wide-spread forms of the disease, that is, carcinoma stage III-IV. In view of the fact total ablation of the larynx, i.e., laryngectomy has so far been an extensively applicable mode of surgical treatment of the disease. Such a surgery though saving or prolonging patient's life, deprives him/her of voice.
People devoid of voice prove to be get out of adaption not only socially but not infrequently professionally. Thus, the problem of vocal rehabilitation can be solved by the following three methods:
logopedic (i.e., learning the so-called `esophageal voice`); PA1 surgical.
Logopedic methods of vocal rehabilitation take much time and involve participation of specialists in diverse trades. Besides, such methods are far from being at all times capable of forming socially adequate voice as per all parameters. Speech of such patients abounds with pauses due to a scant amount of air accumulated in the esophagus. In addition, the methods in question happen to be ineffective in 12to 18 percent of patients.
Further development of technical methods of vocal rehabilitation appears as rather promising, though it needs further improvement, since voice producing appliances feature disagreeable timbre so that patients reject them after one or two months of use.
Surgical vocal rehabilitation has gained development within the recent 20 to 25 years and is based on establishing a narrow anastomosis between the respiratory and alimentary tracts. In this case vocal rehabilitation proves to be practicable without preliminary patient's training.
One prior-art method of surgical vocal rehabilitation (SU, A, 1,405,823) is known to incorporate the following steps carried out in the sequence stated hereinbelow: incising the skin and soft tissues of the ventral neck surface; cutting the larynx off the trachea, which has a dorsal wall, a group of cartilaginous semirings, each having a convex outer surface and a concave inner surface, and a group of interannular spaces, said cartilaginous semirings alternating with said interannular spaces so as to establish conjointly the ventral wall and two lateral walls of said trachea connected to its dorsal wall; cutting off said larynx; severing the esophagus having the ventral wall and a cavity, from said trachea; cutting through said dorsal wall of said trachea to establish an opening having an edge; cutting through said ventral wall of said esophagus to form an opening having an edge situated in level with said opening in said dorsal wall of said trachea; stitching up said edges of said openings situated respectively in said ventral wall of said esophagus and in said dorsal wall of said trachea to form a bypass opening; displacing the first cartilaginous semiring of said trachea to bring it in interaction with said ventral wall of said esophagus above said opening; displacing the ventral wall of said esophagus into its said cavity at the place of interaction of said first cartilaginous semiring of said trachea with said ventral wall of said esophagus; stitching up said first cartilaginous semiring of said trachea with said ventral wall of said esophagus; stitching up said trachea with said skin of said ventral surface of said neck to establish a tracheostoma.
However, displacement of the cartilaginous semiring of the trachea along with a part of its dorsal wall into the esophageal cavity adds to the scope of surgery, which in turn, renders it more traumatic.
Moreover, application of the aforesaid method involves a great number of sutures, which sophisticates surgery.
In addition, necessity for complete severing of the cartilaginous semiring together with a part of the dorsal wall of the trachea affects adversely the wound healing conditions, which impairs postoperative management of patients.